Cytokine storm scale as a prognostic tool of course of viral pneumonia in COVID-19


Citar

Texto integral

Acesso aberto Acesso aberto
Acesso é fechado Acesso está concedido
Acesso é fechado Acesso é pago ou somente para assinantes

Resumo

The aim of the study is to validate the cytokine storm scale (CSS) in a cohort of patients with COVID-19-associated pneumonia to confirm its diagnostic and informative value. Material and methods. The study included 48 patients with COVID-19-associated pneumonia who were admitted to hospital for treatment, and 73 intensive care unit (ICU) patients. The levels of interleukin 6 (IL-6), interleukin 8 (IL-8), interleukin 18 (IL-18), interleukin 10 (IL-10) and procalcitonin (PCT) were measured using enzyme immunoassay, and CSS was calculated. For each biomarker, grade marks were calculated in the range from 1 to 3: at the border concentration of the studied index, 1 grade mark was awarded, with an average - 2, with a high - 3 (normal values were corresponded to 0 marks). A CSS score of more than 6 was associated with a high risk of adverse COVID-19 outcome. Results. When assessing the informativeness of CSS indexes concerning mortality prediction, it was found that it had high sensitivity (78,79%; 95% CI: 0,61-0,91) and specificity (81,12%; 95% CI: 71,2488,80). Also CSS positively and statistically significantly correlated with the NEWS2 scale (0,58; 95% CI: 0,35-0,75), degree of pulmonary damage according to computer tomography data (0,46; 95% CI: 0,20-0,67 ) and the percentage of pulmonary tissue damage (0,38; 95% CI: 0,01-0,61). Conclusion. The developed CSS has a sufficiently high predictive information value in relation to the risk of an unfavorable prognosis of COVID-19 clinical course. The combined prognostic capabilities of the cytokines IL-6, IL-18, IL-10 and PCT, integrated into a single index, make it more likely to identify patients of high risk of death in case of COVID-19-associated pneumonia.

Texto integral

Acesso é fechado

Sobre autores

O. Tkachenko

I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia

Email: tkachenie0mail.ru
197022, Saint Petersburg, 6/8 Lva Tolstogo Str. Tel.: +7 (812) 994-53-24, +7 (812) 338-71-94

M. Pervakova

I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia

Email: margaritalerner@gmail.com
197022, Saint Petersburg, 6/8 Lva Tolstogo Str. Tel.: +7 (812) 994-53-24, +7 (812) 338-71-94

S. Lapin

I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia

Email: svlapin0mail.ru
197022, Saint Petersburg, 6/8 Lva Tolstogo Str. Tel.: +7 (812) 994-53-24, +7 (812) 338-71-94

A. Masing

I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia

Email: alex_mazing0mail.ru
197022, Saint Petersburg, 6/8 Lva Tolstogo Str. Tel.: +7 (812) 994-53-24, +7 (812) 338-71-94

A. Moshnikova

I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia

Email: moshnikova-anna@mail.ru
197022, Saint Petersburg, 6/8 Lva Tolstogo Str. Tel.: +7 (812) 994-53-24, +7 (812) 338-71-94

D. Kuznetsova

I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia

Email: lariwar@mail.ru
197022, Saint Petersburg, 6/8 Lva Tolstogo Str. Tel.: +7 (812) 994-53-24, +7 (812) 338-71-94

I. Kholopova

I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia

Email: irinakholopova@yandex.ru
197022, Saint Petersburg, 6/8 Lva Tolstogo Str. Tel.: +7 (812) 994-53-24, +7 (812) 338-71-94

T. Blinova

I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia

Email: easurkova@mail.ru
197022, Saint Petersburg, 6/8 Lva Tolstogo Str. Tel.: +7 (812) 994-53-24, +7 (812) 338-71-94

E. Surkova

I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia

Email: tvwinova@list.ru
197022, Saint Petersburg, 6/8 Lva Tolstogo Str. Tel.: +7 (812) 994-53-24, +7 (812) 338-71-94

Yu. Polushin

I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia

Email: polushinyus@1spbgmu.ru
197022, Saint Petersburg, 6/8 Lva Tolstogo Str. Tel.: +7 (812) 994-53-24, +7 (812) 338-71-94

A. Afanasiev

I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia

Email: alex-txf@mail.ru
197022, Saint Petersburg, 6/8 Lva Tolstogo Str. Tel.: +7 (812) 994-53-24, +7 (812) 338-71-94

I. Shlyk

I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia

Email: egavrilova70@mail.ru
197022, Saint Petersburg, 6/8 Lva Tolstogo Str. Tel.: +7 (812) 994-53-24, +7 (812) 338-71-94

E. Gavrilova

I.P. Pavlov First Saint Petersburg State Medical University of the Ministry of Healthcare of Russia

Email: irina_shlyk@mail.ru
197022, Saint Petersburg, 6/8 Lva Tolstogo Str. Tel.: +7 (812) 994-53-24, +7 (812) 338-71-94

E. Kornilova

I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia

Email: liza_kornilova@ьk.ru
191015, Saint Petersburg, 41 Kirochnaya Str. Tel.: +7 (921) 951-71-88

D. Ivannikova

I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia

Email: d.ivannikova@yandex.ru
191015, Saint Petersburg, 41 Kirochnaya Str. Tel.: +7 (921) 951-71-88

E. Trophimov

I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia

Email: evgeniy.trofimov@szgmu.ru
191015, Saint Petersburg, 41 Kirochnaya Str. Tel.: +7 (921) 951-71-88

V. Mazurov

I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia

Email: maz.nwgmu@yandex.ru
191015, Saint Petersburg, 41 Kirochnaya Str. Tel.: +7 (921) 951-71-88

Bibliografia

  1. Hu B., Guo H., Zhou P. et al. Characteristics of SARS-CoV-2 and COVID-19. Nat Rev Microbiol. 2021; 19(3): 141-54. doi: 10.1038/ s41579-020-00459-7.
  2. Guan W., Ni Z., Hu Y. et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020; 382(18): 1708-20. doi: 10.1056/NEJMoa2002032.
  3. Zhou F., Yu T., Du R. et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet. 2020; 395(10229): 1054-62. doi: 10.1016/S0140-6736(20)30566-3.
  4. Tay M.Z., Poh C.M., Renia L. et al. The trinity of COVID-19: Immunity, inflammation and intervention. Nat Rev Immunol. 2020; 20(6): 363-74. doi: 10.1038/s41577-020-0311-8.
  5. Li C., Zhao C., Bao J. et al. Laboratory diagnosis of coronavirus disease-2019 (COVID-19). Clin Chim Acta. 2020; 510: 35-46. doi: 10.1016/j.cca.2020.06.045.
  6. Han H., Ma Q., Li C. et al. Profiling serum cytokines in COVID-19 patients reveals IL-6 and IL-10 are disease severity predictors. Emerg Microbes Infect. 2020; 9(1): 1123-30. doi: 10.1080/22221751.2020.1770129.
  7. Fan G., Tu C., Zhou F. et al. Comparison of severity scores for COVID-19 patients with pneumonia: A retrospective study. Eur Respir J. 2020; 56(3): 2002113. doi: 10.1183/13993003.02113-2020.
  8. Ткаченко О.Ю., Первакова М.Ю., Лапин С.В. с соавт. Прогностическая роль исследования цитокинов при COVID-19-ассоциированной пневмонии. Вестник Северо-Западного государственного университета им. И.И. Мечникова. 2021; 1: 59-69. @@Tkachenko O.Y., Pervakova M.Y., Lapin S V. et al. Prognostic value of cytokines in COVID-19 associated pneumonia. Vestnik Severo-Zapadnogo gosudarstvennogo universiteta im. I.I. Mechnikova = Bulletin of the Northwestern State University named after I.I. Mechnikov. 2021; 1: 59-69 (In Russ.). doi: https://dx.doi.org/10.17816/mechnikov61610.
  9. Satis H., Ozger H.S., Aysert Yildiz P. et al. Prognostic value of interleukin-18 and its association with other inflammatory markers and disease severity in COVID-19. Cytokine. 2021; 137: 155302. doi: 10.1016/j.cyto.2020.155302.
  10. Crayne C.B., Albeituni S., Nichols K.E. et al. The immunology of macrophage activation syndrome. Front Immunol. 2019; 10: 119. doi: 10.3389/fimmu.2019.00119.
  11. Qin C., Zhou L., Hu Z. et al. Dysregulation of immune response in patients with coronavirus 2019 (COVID-19) in Wuhan, China. Clin Infect Dis. 2020; 71(15): 762-68. doi: 10.1093/cid/ciaa248.
  12. Jamilloux Y., Henry T., Belot A. et al. Should we stimulate or suppress immune responses in COVID-19? Cytokine and anti-cytokine interventions. Autoimmun Rev. 2020; 19(7): 102567. doi: 10.1016/j.autrev.2020.102567.
  13. Coomes E.A., Haghbayan H. Interleukin6 in COVID-19: A systematic review and meta-analysis. Rev Med Virol. 2020; 30(6): 1-9. doi: 10.1002/rmv.2141.
  14. Lauw F.N., Pajkrt D., Hack C.E. et al. Proinflammatory effects of IL-10 during human endotoxemia. J Immunol. 2000; 165(5): 2783-89. doi: 10.4049/jimmunol.165.5.278.
  15. Lu L., Zhang H., Dauphars D.J. et al. A potential role of interleukin 10 in COVID-19 pathogenesis. Trends Immunol. 2021; 42(1): 3-5. doi: 10.1016/j.it.2020.10.012.
  16. Lippi G., Plebani M. Procalcitonin in patients with severe coronavirus disease 2019 (COVID-19): A meta-analysis. Clin Chim Acta. 2020; 505: 190-91. doi: 10.1016/j.cca.2020.03.004.
  17. Song J., Park D.W, Moon S. et al. Diagnostic and prognostic value of interleukin-6, pentraxin 3, and procalcitonin levels among sepsis and septic shock patients: a prospective controlled study according to the Sepsis-3 definitions. BMC Infect Dis. 2019; 19(1): 968. doi: 10.1186/s12879-019-4618-7.
  18. Hu R., Han C., Pei S. et al. Procalcitonin levels in COVID-19 patients. Int J Antimicrob Agents. 2020; 56(2): 106051. doi: 10.1016/j. ijantimicag.2020.106051.
  19. Vanska M., Koivula I., Jantunen E. et al. IL-10 combined with procalcitonin improves early prediction of complications of febrile neutropenia in hematological patients. Cytokine. 2012; 60(3): 787-92. doi: 10.1016/j.cyto.2012.07.023.
  20. Liang W., Liang H., Ou L. et al. Development and validation of a clinical risk score to predict the occurrence of critical illness in hospitalized patients with COVID-19. JAMA Intern Med. 2020; 180(8): 1081-89. doi: 10.1001/jamainternmed.2020.2033.

Arquivos suplementares

Arquivos suplementares
Ação
1. JATS XML
Baixar

Declaração de direitos autorais © Bionika Media, 2021

Este site utiliza cookies

Ao continuar usando nosso site, você concorda com o procedimento de cookies que mantêm o site funcionando normalmente.

Informação sobre cookies